1. 5

    Wiki Anesthesia billing questions on time / units

    Anesthesia Billing question - We have never added the quanity to our claims for time units. From what I see, the claims have processed at the correct rate. Does anyone know how Medicare or other insurance process anesthesia claims? Do they use the time that we have on the claim to calcuate...
  2. R

    Wiki Data combination MDM table 2021

    Hi I need a clarity in the data tab combination of elements. Provider order 2 each Lab tests, and reviewed the US Abdomen. Kindly clarify me whether this will go to Moderate in MDM table B or I should go to Low MDM in table B.
  3. S

    Wiki Pulling from Problem List

    I know a diagnosis code can be used if problem is documented on or before the date of service, but how far are we able to go back into the patient's chart for this information?
  4. KStaten

    Wiki Coding / Billing Audio-Only Telehealth Visits

    Hello Everyone! :) Here's my silly question for the day. (Brace yourselves, as I am sure more are to come. ;) ) As I have interpreted from articles, the accepted Telehealth services have been expanded to include audio-only telephone calls, as well. (Yay!) Now this is the part where I am...
  5. KStaten

    Wiki What Designates an "Active Involvement" in Plan of Care?

    Hello Everyone! 🙂 According to what I have read (in regards to incident-to billing), in order for a patient to be seen by the PA and still be billed under the doctor, the doctor must do the following: 1) Initiate the treatment 2) Continue to be "actively involved" in the patient's case/ plan...
  6. A

    Wiki Time doesn't support level selected

    Hello! I have a question.... 99215 was billed (documentation supports this code), but only 25 minutes (>50% counseling was spent with the patient). I understand that a provider can select a higher level of service when time is documented... but can time spent lower the billed service to a...
  7. M

    Wiki Acupuncture time

    In need of clarification on codes 97811 and 97814 that require reinsertion per AMA. If the provider performs more than one reinsertion, are we to add the time of all reinsertions together for an accurate number of units on 97811/97814 or does each reinsertion time stand on its own? CPT Assistant...
  8. S

    Wiki Using Counseling/Coordination of Care Time vs Key Components - whichever is higher?

    I'm wondering if you would assign the E/M Level based on the Counseling/Coordination of Care time if it is LOWER than what the documentation meets (within the Hx/Exam/MDM). The guidelines indicate that when the encounter is dominated by counseling/coordination of care than TIME should be the...
  9. B

    Wiki anesthesia time calculation for facility on a UB- IP

    Hello I am looking for resources to support what the facility may bill for anesthesia on a UB. I work with auditors who have the belief that the facility may only bill for the technical component therefore this means the OR time and anesthesia time should match most times as the professional...
  10. J

    Wiki Coding an infusion when there is a "pause" in the infusion

    We are having a difficult time trying to find any information on how to treat this particular instance. The scenario: A patient comes in for infusion, it starts at 8:00 but at 8:45 they pause it because of a reaction, it is resumed again at 9:00 and continues for another hour. Is that 15...
  11. T

    Wiki 99239

    is "more than 30 min" acceptable for 99239?
  12. V

    Wiki Duration Of Mechanical Vent for ICD10-PCS

    If a patient is intubated in the field and comes to the ED, placed on the ventilator in ED and later admitted, when do you count the start of the ventilator time? Coding clinic states that if the patient is intubated PTA, the start time for counting duration is the time of admission. Is that...
  13. A

    Wiki Consult before Colonoscopy

    Can I get feedback on how you are billing your consults before a colonoscopy? Thank you very much for your time!
  14. J

    Wiki Advance Care Planning - We use time based billing

    We use time based billing in our office. Does this make us exempt from using a CPT code and advanced care planning code together? IE: (We see nursing home patients) 99310 and 99497 is what's I'd like to use together - with all the proper documentation. If we are billing based off time can I use...
  15. J

    Wiki Advanced Care Planning-We use time

    We use time based billing in our office. Does this make us exempt from using a CPT code and advanced care planning code together? IE: (We see nursing home patients) 99310 and 99497 is what's I'd like to use together - with all the proper documentation. If we are billing based off time can I use...
  16. M

    Wiki MI's and Stents

    what are the rules for using the stent code 92941 for MI's? must it be within a certain time frame? If so what is that time frame? thanks
  17. S

    Wiki Mod 79, 78 or 58 for Port A Cath

    Hello, we did a modified radical mastectomy on a patient and they are in the global. We are now doing a port-a-cath placement for their chemo. Would that be considered unrelated? At the same time the Dr also drained a seroma from the mastectomy site. I am thinking that would be a mod-78, so...
  18. T

    Wiki Critical care visit requires chief complaint??

    I have a physician that sees a hospital patient and lists his time to bill critical care, but he does not give a chief complaint. If this permitted for critical care since it time driven?
  19. K

    Wiki Extended ER Services

    Would like to get some feedback on what different facilities are doing with patients who need extended emergency room services. Is there a potential charge for this extended time? Or do you use Observation code? Appreciate any feedback for this situation! Kris
  20. B

    Wiki Points on how to pass the CPC exam B Inman

    Can you give me some tips on how to answer the questions in less time. I am waiting on my score now, over a week ago I took the exam. I ran out of time with too many problems not answered. That was my first time taking the exam. Can you give me some pointers on how to spend less time on the...
  21. A

    Wiki Coding Based on Time

    I have a provider questioning the coding of time. For example a 99213 is 15 minutes and 99214 is 25 minutes. (I realize it has to be greater than these "typical" times with greater than 50% in counseling and coordination). The provider is saying if it is 21 minutes you would round up to the...
  22. K

    Wiki Combining Time in a split/shared visit

    Are you able to combine face-to-face time between the patient and the NP and the patient and the Attending in a split/shared visit to determine one time based code? Example: Patient comes in to discuss treatment options for urinary incontinence. The Provider has a face-to-face discussion for 15...
  23. L

    Wiki question on remoted job

    Speaking to remote job, I am wondering how you are able to manage your time to do the training, which is in the core office hours time (8-5) "mandatory", while maintain the actual full time job going on?
  24. B

    Wiki CPC w/ over 3 years experience looking for REMOTE coding

    Hello! I am looking for a remote coding position; either part time or full time. I have several years experience, as well as a Bachelors of Science in Healthcare Administration. Please feel free to contact me via email with any opportunities and I will provide my complete resume. Best regards...
  25. P

    Wiki Help with billing Capsule Endoscopy

    Hello fellow AAPC members. We had to let our biller go a few weeks ago and have been struggling to pick up where she left off. I have to bill the following and I am not sure how to prepare the claim. 1. a Capsule Endoscopy done in the hospital - Professional fee only. 2. A Capsule Endoscopy...
  26. C

    Wiki Failed CPC exam- first attempt with 65%. Need advice.

    Hi everyone, I am looking for advice on passing my CPC exam on my second attempt which is coming up in a few weeks. My problem with the first exam was with the amount of time given to us. How could anyone answer 150 questions within such a short amount of time? I utilized all of the official...
  27. J

    Wiki Cpt 22310

    I have a new physician to our practice that states she has always billed for CPT 22310 (Closed treatment of vertebral fracture w/o manipulation) in conjunction to either an office visit or hospital follow up. I was under the impression that in order to bill this code the doctor must be present...
  28. L

    Wiki Critical care

    How much critical care time would you bill in this situation. Provider initiates care 02:30 he signs his note at 03:43. Never says critical care time spent anywhere in his note. Patient was seen in the PICU - which I know doesn't necessarily mean critical care. He does an addendum starting @...
  29. T

    Wiki new patient help please

    We have a physician that is seeing a patient for the first time from China attending school here. Blue cross ppo. The patient has no problems she only came in to get a Gardasil shot. The doctor spent time with the patient going over problems/history/family history etc. How can this be billed...
  30. L

    Wiki Physician coder needed for onsite full time position Ruston,LA

    Currently looking for a full time coder for a multi specialty physician practice in Ruston, Louisiana. Job is an onsite position. M-F / 8-5. Please send resumes to lknight@green-clinic.com or fax to 318-251-6116 attn: LKnight
  31. M

    Wiki coder

    My doctor is wanting to use over the medication to make his risk higher and charge a 99214. Eztablished patient and stable problem HTN. No labs or other complexity ordered or reviewed. He feels if he tells the patient to take 3 ibruprofen at a time instead of the usual 2. It should be...
  32. J

    Wiki Cardiology codes for vein mapping?

    Does anyone know a specific code for lower extremity vein mapping? This is the first time I have seen that documented by my cardiology group.
  33. A

    Wiki Need help with homework

    Having a difficult time with homework with coding from my ICD-10-CM code book. Looking for help to see if some of my answers are correct. Message if you can help me please and thanks
  34. D

    Wiki Looking for part time

    CPC looking for CT part time job I'm looking for part time medical billing or medical coding work in the Farmington, Avon CT area. I currently have a full time job working 7-4 but am looking for additional employment in the medical field. I have 12+ years of experience with medical billing...
  35. A

    Wiki Prolonged services

    Hello all, I need more guidance or help into the process of billing for prolonged services along with an E/M office visit. My specialty is a pediatric neurology and my provider spends additional time on reports and such for the patient care on autism patients. Please if there is anybody who...
  36. J

    Wiki speech pathology

    how can I get 92630 paid with 92507. seem to be denying 92630 all time
  37. C

    Cpt 96103 - Clinical Social Worker

    We are a Pain Management clinic(private physician practice) and recently hired a Licensed Clinical Social Worker. However, I have a question about billing for her psych testing. She wanted to bill a 96103 for her psych testing, but I told her she could not because the test is not administered...
  38. C

    Wiki Cpt 96103

    We recently hired a Licensed Clinical Social Worker. However, I have a question about billing for her psych testing. She wanted to bill a 96103 for her psych testing, but I told her she could not because the test is not administered by a computer. She told me it was the same type of test...
  39. C

    Wiki Allergy to Lidocaine testing

    I believe that I use 95018 for the drug allergy testing and list the number of tests performed. The doctor believes it is acceptable to bill 95180 with a time unit because the testing was done of a period of time with increasing dosages of Lidocaine. Finally, he ordered 2mg of Lidocaine for the...
  40. M

    Wiki Billing 99408

    If my provider wants to bill the 99408 code for alcohol and/or substance use screening, 2 questions: 1. Does the 15-30 minutes include the time spent in the exam or is this an additional 15-30 minutes on top of the exam spent doing the screening? 2. Since this is a screening code along with...
  41. G

    Wiki Acute vs Chronic

    What is the criterion for coding for Chronic Conditions. When is something considered Chronic? Is there a time frame involved? Thanks
  42. G

    IV Infusions

    A patient is given Zofran push, documentation says given and injection time is charted would we not charge for push.
  43. D

    Wiki Face to face time with e/m coding

    Can someone tell me if face to face time has to be consecutive or if the dr can see the patient, send them to audiology for a test,and then see the patient again to review the results of the audiology test? Can she bill for the time before and after seeing the audiologist?
  44. P

    Wiki 2 Anesthesiologists, 1 Case

    When one anesthesiologist of the same group takes over for another anesthesiologist, the case can be billed in one of two ways; provider who started the case or the one with the most time spent on the case. Taking a poll to see which one is the preferred method. Thanks for your responses.
  45. kathymoon

    Wiki Coding a 99215

    I have an internist that sees many geriatric patients. As I am reviewing his charts, he is charging a 99215. The patient is coming in for a 6-month or 1 year check up. He documents a comprehensive history and a comprehensive physical exam. He is covering 4 or more chronic conditions that are...
  46. S

    Wiki Split/Shared Visits based on Counseling Time

    I am looking for any documentation from CMS regarding split/shared visits that states the service can be billed based on time when over 50% of the time spent by both the NPP and MD/DO was for counseling/coordination of care. Does anyone know of any references directly from Medicare? Thanks, Sue
  47. J

    Wiki Medical Biller (laboratory) Full time or Part Time

    I am looking for a Medical biller for a newer company that is Located in Garden City Park NY. If interested please forward your resume to or questions to jwinges@earthlink.net.
  48. K

    Wiki Billing TCM

    Am I reading correct, we no longer have to hold the TCM codes 99495 and 99496 for 29 days after discharge? They can now be billed at time of service? I hope so;) this would make life much easier!!
  49. S

    Wiki Gegamd@gmail.com

    Looking for part time CPPM NYC queens area
  50. J

    Wiki Time in E/M coding

    I went to a conference recently where I was told in an E/M panel Q&A that a statement after the Discussion portion of the note stating "31 minutes of the 60 minute visit spent in coordination and counseling of care" was not adequate to code on the basis of time, even if the Discussion documented...